Firms obviously choose to insure risk-averse workers when the premium is fair. They may choose to do so even if the premium is slightly higher than the expected cost. Nevertheless, if a firm’s expected health cost is significantly lower than the premium, it may choose not to offer insurance to workers. As we have just observed, small firms have higher variances in health costs. Hence, relative to large firms, more small firms will have expected costs that are significantly below the offered premium, and they choose not to offer insurance to workers. We have described a simple employment process and time-path of a firm facing workers.
